JOHN MISA – Internal Medicine Physician, NPI 1821075946

JOHN MISA is a healthcare provider. based in St louis park, Minnesota. specializing in INTERNAL MEDICINE. They hold a License No. 44461 (MN). The NPI Number for JOHN MISA is 1821075946

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
JOHN MISA
NPI
1821075946
Phone
Not provided
Address
3800 PARK NICOLLET BLVD
Enumeration Date
29 December 2005
Last Update Date
16 October 2024

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Secondary Phone
6512938100
Graduation Year
1995 (31 years ago)
PAC ID
7012059355
Group Practice PAC ID
1759293954
Professional Enrollment ID
I20100125000282
Address ID
MN551071805SA205XXSXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,636 INTERNAL MEDICINE in MN

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Provider Addresses for JOHN MISA

  • 3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    CREDENTIALING

    ST LOUIS PARK, MN 554162527

    Phone:

    Type: Mailing

  • Blaisdell Av, West Franklin Avenue, Whittier, Minneapolis, Hennepin County, Minnesota, 55405, United States

    MINNEAPOLIS, MN 554042414

    Phone: (952) 993-8000

    Type: Location

  • 205 WABASHA ST S

    SAINT PAUL, MN 551071805

    Phone: (952) 967-5584

    Fax: (651) 293-8232

    Type: Location

  • 8170 33RD AVE S # MS 21110Q

    BLOOMINGTON, MN 554254516

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-01-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100125000282IInternal MedicineMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55416)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759293954View full group profile

Reviews

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Frequently asked questions

How do payers reference JOHN MISA?
For JOHN MISA, use NPI 1821075946 as the unique 10-digit identifier.
Is there an active status for JOHN MISA?
For scheduling context, JOHN MISA is shown as active in the registry.
What area of care is associated with JOHN MISA?
JOHN MISA's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JOHN MISA?
Travel planning: use St Louis Park, Minnesota as the reference point for JOHN MISA, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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